Predictors of Outcomes Following Fasciectomy for Dupuytren's Disease in Diabetic and Non-Diabetic Patients.
J Hand Surg Asian Pac Vol
; 22(3): 309-314, 2017 Sep.
Article
en En
| MEDLINE
| ID: mdl-28774253
ABSTRACT
BACKGROUND:
The aim of this study was to compare clinical outcomes, and identify predictors thereof, after fasciectomy for Dupuytren's disease in a series of diabetic patients compared with non-diabetic patients.METHODS:
Thirty-eight patients were examined following partial palmar and/or digital fasciectomy for Dupuytren's disease (11 diabetics, 27 non-diabetics). Each patient was assessed for degree of pre- and post-operative flexion contractures at the MCP and PIP joints, post-operative Patient Evaluation Measure (PEM) total score, post-operative grip strength, limited joint mobility (LJM), recurrence, extension, and a composite outcomes score based upon grip strength and the degree of joint contractures. All measurements in the diabetic cohort were compared to those in the non-diabetic group, and a logistic regression analysis was performed to identify the predictive value of several variables on outcomes.RESULTS:
Complication rates between the two groups were statistically similar (p = 0.67). There were no significant differences in pre-operative MCP (p = 0.69), post-operative MCP (p = 0.39), pre-operative PIP (p = 0.40), or post-operative PIP (p = 0.13) joint flexion contractures between the two groups. Additionally, there was no significant difference in extension (p = 0.35) or recurrence (p~1) rates, post-operative grip strengths (p = 0.64), or PEM total scores (p = 0.32). However, the rate of LJM was significantly higher in the diabetic population (p = 0.02). Both female gender (p = 0.01) and a non-smoking status (p = 0.04) were found to be predictive of better outcomes following fasciectomy. Diabetes was not found to be an independent predictor of outcome (p = 0.73).CONCLUSIONS:
Clinical results after fasciectomy for Dupuytren's disease in diabetic patients are not different from results obtained in non-diabetic patients. Diabetes is not independently predictive of surgical outcomes. Female gender and non-smoking status are independent predictors of a better outcome following fasciectomy.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Diabetes Mellitus
/
Contractura de Dupuytren
/
Evaluación del Resultado de la Atención al Paciente
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Hand Surg Asian Pac Vol
Año:
2017
Tipo del documento:
Article
País de afiliación:
Estados Unidos